Last week a rape victim who was denied emergency contraception finally saw justice done â€“ even if it was only on TV. On February 14, ABC aired an episode of Boston Legal entitled "Smile" in which an 18 year-old girl, pregnant because she was denied access to EC at a Catholic hospital after being raped, insisted on suing the hospital and taking her case to trial. And since this case was tried in TV-land instead of in a real-life courtroom, she won.

But even that one fantasy victory over Catholic policy on contraception for rape victims was too much for some people to bear.

Catholic League president William Donohue, a reliable pitbull on the pantsleg of apostasy, always knows who's to blame when the church looks bad in public -- Hollywood. Not that he's really worried about it, of course.

We've already won. Who really cares what Hollywood thinks? All these hacks come out there. Hollywood is controlled by secular Jews who hate Christianity in general and Catholicism in particular. It's not a secret, okay? And I'm not afraid to say it. ... Hollywood likes anal sex. They like to see the public square without nativity scenes. I like families. I like children. They like abortions. I believe in traditional values and restraint. They believe in libertinism. We have nothing in common. But you know what? The culture war has been ongoing for a long time. Their side has lost.

So as a staunch believer in "restraint and traditional values," Donohue naturally felt a moral obligation to respond to the Boston Legal episode by once again rounding up the usual Hollywood suspects.

â€œIf there is one Hollywood producer who has shown himself to be positively obsessed with Catholicism, it is David E. Kelley. His treatment of Catholicism on â€˜Ally McBeal,â€™ â€˜Picket Fences,â€™ â€˜Chicago Hope,â€™ â€˜Snoops,â€™ â€˜The Practiceâ€™ and â€˜Boston Legalâ€™ is so well known that we have a big fat file on him. This time Kelley has decided to hook up with the equally anti-Catholic folks at the ACLU: the Pennsylvania affiliate is providing a viewing guide that can facilitate discussions at a â€˜Boston Legal Viewing Partyâ€™ (courtesy of RaisingHerVoice.org, a project of the state affiliate).
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â€œThe Pro-Life Office of the Bishops Conference, by the way, holds that â€˜A woman who has been raped should be able to defend herself from a potential conception and receive treatment to suppress ovulation and incapacitate sperm. If conception has occurred, however, a Catholic hospital will not dispense drugs to interfere with implantation of a newly conceived human embryo.â€™ But donâ€™t look for the party animals at a â€˜Boston Legal Viewing Partyâ€™ to be instructed in such nuances."

So even the Pro-Life Office of the Bishops Conference maintains that "a woman who has been raped should be able to defend herself from a potential conception and receive treatment to suppress ovulation and incapacitate sperm." More specifically, the U.S. Roman Catholic church's Ethical and Religious Directives for Catholic Health Care Services clearly state that the church does not approve contraceptive interventions that "...either in anticipation of the marital act, or in its accomplishment or in the development of its natural consequences, have the purpose, whether as an end or a means, to render procreation impossible." However â€“ perhaps as a semi-admission that "the marital act" and "rape" are not always interchangeable terms â€“ the Directives make a semi-concession for women who become victims of sexual assault. Directive 36 states:

"Health care providers should cooperate with law enforcement officials, offer the person psychological and spiritual support and accurate medical information. A female who has been raped should be able to defend herself against a potential conception from the sexual assault. If, after appropriate testing, there is no evidence that conception has occurred already, she may be treated with medications that would prevent ovulation, sperm capacitation, or fertilization. It is not permissible, however, to initiate or to recommend treatments that have as their purpose or direct effect the removal, destruction, or interference with the implantation of a fertilized ovum."

But what does that really mean? What is "appropriate testing," and what kind of contraceptive information and treatment does a woman who is a rape victim really receive at a Catholic hospital? According to a comprehensive survey [pdf link] of 597 U.S. Catholic hospitals conducted by Catholics for a Free Choice in 2002, only five percent of the hospitals provided EC on request, and an additional 23% provided it to rape victims only. Often the request for emergency contraception brought answers like these:

â€œNo Catholic hospital will ever do that. They donâ€™t take rape cases.â€?

â€œHoney, this is a Catholic hospital, you couldnâ€™t even come close here.â€?

This guideline is well-intentioned, yet its complexity allows for interpretation and discretion on the part of local bishops, hospital administration and staff. Each Catholic hospital is free to interpret the Directive and implement either a liberal or a conservative policy. That process is subject to pressure typically from conservative bishops and lay Catholic groups calling for strict application of Catholic teachings in Catholic health facilities. They argue that sexual assault is not an acceptable reason for abortion therefore it should not be an acceptable reason for contraception.

Some aspects of the Directive are meaningless. For example, the Directive suggests that providers administer a pregnancy test to each sexual assault patient. Because EC must be given within five days of intercourse, a pregnancy test will not identify an established pregnancy. A pregnancy test can only tell if a woman was already pregnant prior to the assault. EC does not affect an existing pregnancy, therefore even if a women was unknowingly pregnant, the EC would not cause an abortion. Either way, the pregnancy test satisfies neither the medical need nor Catholic teaching. It only creates a barrier between the sexual assault patient and protection from pregnancy.
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Rev. Kevin Oâ€™Rourke, director of the Center for Health Care Ethics at St. Louis University, has interpreted the Directive to mean that Catholic hospitals should administer ovulation tests to sexual assault patients before giving EC. In his view, if the ovulation test and the date of the womanâ€™s last menstrual period suggest that she has not yet ovulated, then the EC may delay ovulation and avert a pregnancy, a process consistent with Catholic doctrine. If the woman is currently ovulating, he recommends that EC should not be given. This is unworkable for two reasons. First, an ovulation test cannot identify the moment of ovulation as accurately as Oâ€™Rourke suggests. Second, an ovulating woman is most at risk of pregnancy and in need of EC. To deny a sexual assault patient EC because she is ovulating is to defeat the reason for giving EC.

So it turns out that Directive 36 is just another way to say Catch-22. Last year, in a column on a Colorado bill that would have mandated EC availability for rape victims, Denver Post writer Jim Spencer put the problem in language anyone can understand (archive link to this column is only by subscription, so thanks to Sivacracy and Echidne of the Snakes for preserving the text).

Imagine two rape victims taken to the same hospital emergency room. Imagine them put in adjoining examination rooms.

Let's say they have identical injuries.

Presume everything about them is the same except for where they are in their menstrual cycles.

Do they deserve access to the same medical treatment?

At most Catholic hospitals in Colorado, they can't get it.

The protocol of six Catholic hospitals run by Centura calls for rape victims to undergo an ovulation test.

If they have not ovulated, said Centura corporate spokeswoman Dana Berry, doctors tell the victims about emergency contraception and write prescriptions for it if the patient asks.

If, however, the urine test suggests that a rape victim has ovulated, Berry continued, doctors at Centura's Catholic hospitals are not to mention emergency contraception. That means the victim can end up pregnant by her rapist.
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This isn't about abortion; it's about crime victims. The so-called EC bill is a symbol of mainstream American values. It comforts the afflicted. It restores control after a terrible trauma. It allows individuals to have information.
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When religion and science get mixed up, no one benefits.

That includes Colorado's Catholic hierarchy, which orders doctors at its hospitals not to do their jobs as defined by the American Medical Association.

It includes [Governor] Owens, who argues that religious freedom allows private religious hospitals to collect public dollars, then lets them treat rape victims differently based on a definition of conception that differs from that of the National Institutes of Health.

But most of all, it includes those befouled by a vicious crime. Without an emergency-contraception notification law, they can easily end up victimized a second time for nothing more than the vagaries of their cycle.

Science ... suggests that emergency contraception that employs the hormone progesterone rather than a mixture of the hormones estrogen and progesterone will not keep a fertilized egg from attaching to the uterine wall.
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That ought to answer Catholic concerns that life begins when a sperm fertilizes an egg.

But Tim Dore, executive director of the Colorado Catholic Conference, says directives from the U.S. Conference of Catholic Bishops require Catholic hospitals "to err on the side of life."

Stamm knows of no test that can determine whether a rapist has fertilized his victim's egg in the period when emergency contraception works.

Neither do Catholic hospitals.

So they rely on a nonspecific ovulation test that condemns every rape victim who might possibly have an egg in her reproductive system to a different standard of medical care.

This, says the Catholic Church, is religious freedom.

This, the governor agrees, is a constitutional right.

This, the rest of us must force them to understand, is madness.

Owens vetoed the Colorado EC bill, and not all the rest of us got the message, either. Certainly not Bill Donohue, who wound up his rant on Boston Legal's February 14 episode with this: â€œWhoever thought that Hollywood and the ACLU would unite to present the Catholic Church with a Valentineâ€™s Day gift? And all along I thought these guys didnâ€™t like to partyâ€”I just thought they were always out of their minds.â€?

Party on, Bill. The rest of us will just have to do our best not to get raped near a hospital starting with "Saint" â€“ unless, of course, we've got the phone number for Boston Legal.